OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program

ICR 201510-0938-001 · OMB 0938-1175 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form CMS-10431 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program Form and Instruction Modified Repair queued
PQ 2016-09-26 CMS-10431_Supporting Statement A - Passback.docx Supporting Statement A Uploaded 2016-09-26 Available
PCHQR PRA_Appendix A 04_07_2015 revised (508 ready ef).docx Supplementary Document Uploaded 2015-05-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
202342 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program Form and Instruction Modified
ICR Details
0938-1175 201510-0938-001
Historical Active 201505-0938-005
HHS/CMS 21324
PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program
Revision of a currently approved collection   No
Regular
Approved with change 09/27/2016
Retrieve Notice of Action (NOA) 10/07/2015
  Inventory as of this Action Requested Previously Approved
09/30/2019 12/31/2017 11/30/2016
400,631 0 413,556
200,425 0 206,891
0 0 0
Section 3005 of the Affordable Care Act authorizes the establishment of a quality reporting program for PPS-exempt cancer hospitals (PCHs). This is an update to the previously approved PCHQR Program PRA submission. Based on the FY2016 IPPS/LTCH rule we are removing the six Surgical Care Improvement Program (SCIP) measures and adding three CDC NHSN measures.
PL: Pub.L. 111 - 48 3005 Name of Law: Affordable Care Act
  
None
0938-AS41 Final or interim final rulemaking 80 FR 49325 08/17/2015
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 400,631 413,556 0 -12,925 0 0
Annual Time Burden (Hours) 200,425 206,891 0 -6,466 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The burden decreased becasue six surgical care improvement project (SCIP) measures were removed. The total change in burden based on the changes in this year's rule are to decrease responses by 12,925 responses per year, which equates to a decrease of 6466 hours per year.
$20,800
No
No
Yes
No
No
Uncollected
Denise King 410 786-1013 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/07/2015